Observation of the clinical efficacy of the bone filling bag vertebroplasty for the treatment of osteoporotic vertebral compression fractures / 中国骨伤

OBJECTIVE@#To explore the clinical effects of bone filling bag vertebroplasty in treating osteoporotic vertebral compression fractures.@*METHODS@#The clinical data of 127 patients (145 vertebrae) with osteoporotic vertebral compression fractures who corresponded the criteria of inclusion and exclusion from December 2015 to June 2017 were retrospectively analyzed. Responsible vertebral bodies were identified by clinical situation, X-rays, CT scan, MRI. Among them, 95 cases (110 vertebrae) were treated by percutaneons kyphoplasty (PKP group), there were 34 males (42 vertebrae) and 61 females (68 vertebrae), with an average age of (73.92±7.14) years, 47 thoracic vertebra (T₈-T₁₂) and 63 lumbar vertebra (L₁-L₅). Other 32 patients (35 vertebrae) were treated by bone filling bag vertebroplasty(bone filling bag vertebroplasty group). There were 11 males (12 vertebrae) and 21 females (23 vertebrae), with an average age of (71.56±7.89) years, 16 thoracic vertebra (T₉-T₁₂) and 19 lumbar vertebra(L₁-L₅). Postoperative pain after 3 days, vertebral body height, improvement of lumbar function were recorded and bone cement diffusion and leakage were observed by X-rays.@*RESULTS@#All operations were successful and no complications were found. In bone filling bag vertebroplasty group, operation time was (31.75±4.99) min, postoperative VAS score at 3 days was(2.38±0.94) points, anterior and middle height of the vertebral body were(19.54±2.36) mm and (18.16±2.65) mm, respectively; ODI score was(25.19±5.49) points, all above items after operation were better than preoperation(0.05). Bone cement was patchy, clumpy or slightly dispersed by X-rays at 3 days after operation, the leakage rate of bone cement in bone filling bag vertebroplasty group was 2.86%(1/35), while was 6.36%(18/110) in PKP group, all of them were "trailing sign", there was significant difference between two groups (<0.05).@*CONCLUSIONS@#The clinical effect of bone filling bag vertebroplasty in the treatment of osteoporotic vertebral compression fractures is similar to percutaneous kyphoplasty, it can effectively relieve the pain, restore part vertebral body height and obviously reduce the leakage rate, with safer, it is a simple, rapid and effective therapeutic method.

Effects of different treatments on patients with osteoporotic fracture after percutaneous kyphoplasty / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate effects of different treatments on patients with osteoporotic vertebral fracture after percutaneous kyphoplasty in pain and function.</p><p><b>METHODS</b>From March 2010 to March 2012,138 patients (165 vertebrae) with thoracic and lumbar vertebral osteoporotic fracture were randomly divided into three groups (control group, treatment group and comprehensive group), 46 cases in each group, and all patients were treated by PKP. Control group were treated with calcium and calcitriol after operation, treatment group added salmon calcitonin see calcimar based on control group, comprehensive group added incrementality waist musculi dorsi function exercise based on treatment group. VAS, ODI scores and BMD before operation, 3 d, 2 weeks, 1 month, 6 months and 12 months after operation were detected and compared.</p><p><b>RESULTS</b>All operation were performed successfully,38 cases (45 vertebrae) in control group, 36 cases (44 vertebrae) in treatment group and 40 cases (49 vertebrae) were obtained complete following up, there was no significant meaning in following time among three groups (P>0.05). Postoperative VAS and ODI scores at 3 d, 2 weeks and 1 month among three groups were lower than that of before operation (P<0.01). Compared with control group, postoperative VAS score at 3 d, 2 weeks and 1 month were decreasedin treatment group and comprehensive group, but there was no significant meaning in ODI scores (P>0.05). At 6 and 12 months after operation,there was no significant differences in VAS and ODI between control group and treatment group (P>0.05), while VAS score in comprehensive group decreased much than other two groups,decreased continuously (P<0.01). At 12 months after operation, BMD among three groups were increased more than preoperative,and BMD in comprehensive group was more obviously than that of in control and treatment group.</p><p><b>CONCLUSION</b>PKP, an effective method for the treatment of thoracic and lumbar vertebral osteoporotic fracture, could improve short-term clinical effects by adding calcitonin with calcium supplements and activated vitamin D. Waist musculi dorsi function exercise could improve long-term clinical effects of PKP and improve quality of life.</p>